3 hours ago, Phillyterp85 said:

What does this have to do with Roe v Wade?  

 

Because their work is being attacked by extremist politicians, and they are at risk of facing penalties for doing their job. Why decide to go to school to become OB-GYN when you can choose another specialty that isn’t being attacked?

Btw. St. Luke’s is 90 minutes drive from Hedrick Medical Center. Makes a difference for the women in that community 

It's not just rural areas. Even the major hub hospital systems are having a hard time adequately staffing delivery centers nowadays. It was already a fairly strenuous gig and one of the more sued specialties so that's not completely new but this BS certainly didn't help. And it won't take a massive percentage of lost work force to dangerously strain the system. Maternal/fetal death rates have been rising for years in the US (even if you treat the 2021 spike as a bit of an aboration). I expect that to continue. 

Did you see my fish eggs?

2 hours ago, toolg said:

Because their work is being attacked by extremist politicians, and they are at risk of facing penalties for doing their job. Why decide to go to school to become OB-GYN when you can choose another specialty that isn’t being attacked?

Btw. St. Luke’s is 90 minutes drive from Hedrick Medical Center. Makes a difference for the women in that community 

Again, what does this have to do with the tweet you posted?   The OB-GYN didn’t leave.  If you read the actual story instead of a misleading tweet, the OB-GYN physician at Hedrick is continuing his pre natal and post natal services there and joining the delivery unit at St Luke’s North.  So what you posted above has nothing to do with this situation. They are consolidating the delivery part of the practice to St Luke’s North.  
This is part of an ongoing trend that has been happening in rural maternity units for some time now.  Again, this same exact thing happened in 2016 with Hedrick being on the receiving end of the Wright Memorial hospital closing its maternity unit.

I never said it didn’t make a difference for the women in that community.  Of course it does.  I asked what does Roe v Wade have to do with it? Last I checked Roe v Wade was still in effect in 2016 when this same exact thing happened to this same exact medical center except that time it was Wright closing its maternity unit and Hedrick gaining patients.
 

10 hours ago, Phillyterp85 said:

Again, what does this have to do with the tweet you posted?   The OB-GYN didn’t leave.  If you read the actual story instead of a misleading tweet, the OB-GYN physician at Hedrick is continuing his pre natal and post natal services there and joining the delivery unit at St Luke’s North.  So what you posted above has nothing to do with this situation. They are consolidating the delivery part of the practice to St Luke’s North.  
This is part of an ongoing trend that has been happening in rural maternity units for some time now.  Again, this same exact thing happened in 2016 with Hedrick being on the receiving end of the Wright Memorial hospital closing its maternity unit.

I never said it didn’t make a difference for the women in that community.  Of course it does.  I asked what does Roe v Wade have to do with it? Last I checked Roe v Wade was still in effect in 2016 when this same exact thing happened to this same exact medical center except that time it was Wright closing its maternity unit and Hedrick gaining patients.
 

The town of Chillicothe, MO lost its maternity ward. St. Luke's North is 90 minutes away. The trend will continue as long as OB-GYN  specialists are being attacked for doing their jobs.

16 minutes ago, toolg said:

The town of Chillicothe, MO lost its maternity ward. St. Luke's North is 90 minutes away. The trend will continue as long as OB-GYN  specialists are being attacked for doing their jobs.

Ffs…..THE OB-GYN didn’t leave!  Not only did he not leave the state, he didn’t even leave the St Luke’s health system.  
Again, the same exact thing happened in 2016, with St Luke’s closing the maternity unit at Wright Memorial Hospital and having all deliveries for those patients being moved to the Hedrick maternity unit.

When you find an situation of an OB-GYN leaving the state to go practice in another state that didn’t pass these anti-abortion laws, and this causes a maternity unit to have to shut down, then that would be an example of the Roe v Wade ruling impacting a practice.

But that’s not what happened here. 

33 minutes ago, toolg said:

The town of Chillicothe, MO lost its maternity ward. St. Luke's North is 90 minutes away. The trend will continue as long as OB-GYN  specialists are being attacked for doing their jobs.

If you continuously misrepresent and overstate the problem for political purposes you're going to be ignored during the times when abortion policy really does play a factor in these maternity ward mergers and closings.

4 minutes ago, Phillyterp85 said:

Ffs…..THE OB-GYN didn’t leave!  Not only did he not leave the state, he didn’t even leave the St Luke’s health system.  
Again, the same exact thing happened in 2016, with St Luke’s closing the maternity unit at Wright Memorial Hospital and having all deliveries for those patients being moved to the Hedrick maternity unit.

When you find an situation of an OB-GYN leaving the state to go practice in another state that didn’t pass these anti-abortion laws, and this causes a maternity unit to have to shut down, then that would be an example of the Roe v Wade ruling impacting a practice.

But that’s not what happened here. 

Women in Chillicothe, MO have to travel 90 minutes further to find a maternity ward. There are many cases when a woman goes into labor and gives birth in less than 90 munutes. Doctors are reluctant to enroll in OB-GYN and hospitals are cutting back services. This trend will continue as long as the profession is attacked.

https://www.pbs.org/newshour/show/maternity-care-deserts-grow-across-the-us-as-obstetric-units-shut-down

Quote

In many parts of the country, there are fewer places to give birth. Obstetric units have closed in New Hampshire, New York, Delaware, Florida, Mississippi, Texas, Wyoming and other states — creating maternity care deserts for millions of Americans. 

https://www.washingtonpost.com/politics/2023/03/21/idaho-hospital-baby-delivery-abortion/

Quote

The closure of Bonner’s labor and delivery department follows a national trend that researchers have associated with potentially dangerous out-of-hospital and preterm births. Access to obstetric services has been on the decline for years in rural areas, with at least 89 obstetrics units in rural U.S. hospitals closing their doors between 2015 and 2019, according to the American Hospital Association. More than half of rural counties — home to 2.2 million women of childbearing age — are now maternity-care deserts.

Some obstetricians say the problem has been exacerbated by the recent passage of laws criminalizing abortion, which can make recruiting and retaining physicians all the more difficult.

There is a crisis brewing in this country, and overturning Roe v. Wade contributes to it.

Yes, there is a problem with OB-GYN access in rural areas. 

Yes abortion policies in certain states are contributing to the problem.

But the problem predates the Dobbs decision, and while there are certain closures that you can point to as being primarily influenced by abortion policies in specific states, pointing to Dobbs every time a maternity ward closes just makes it easy to undercut the argument when it's applicable.

11 minutes ago, JohnSnowsHair said:

Yes, there is a problem with OB-GYN access in rural areas. 

Yes abortion policies in certain states are contributing to the problem.

But the problem predates the Dobbs decision, and while there are certain closures that you can point to as being primarily influenced by abortion policies in specific states, pointing to Dobbs every time a maternity ward closes just makes it easy to undercut the argument when it's applicable.

^^^^This!

18 minutes ago, toolg said:

There is a crisis brewing in this country, and overturning Roe v. Wade contributes to it.

I'm not disagreeing with that.  But THIS EXAMPLE you cited from this extremely misleading tweet is NOT an example of this.  The Hedrick maternity unit isn't closing its doors because the OB-GYN there left the state due to anti-abortion laws.   As @JohnSnowsHair said, if you just assign blanket blame to the Dodds decision anytime something like this happens, it actually hurts the credibility of the argument. 

https://centerforhealthjournalism.org/our-work/insights/does-closing-hospitals-and-maternity-wards-mean-worse-care-phillys-poorest

"From 1997 to 2012, 13 out of 19 hospital maternity units in the city of Philadelphia shut down"

Must be because of those strict anti-abortion policies in PA and Philly.

https://www.wkbw.com/news/local-news/another-western-new-york-hospital-announces-cuts-to-services

"Catholic Health says it will close the maternity ward, among many other changes, at Mount St. Mary's Hospital this summer. This is now the second hospital in our region to make that decision just this year."

Ah those damned anti-abortion policies in New York strike again!

 

 

21 minutes ago, Phillyterp85 said:

I'm not disagreeing with that.  But THIS EXAMPLE you cited from this extremely misleading tweet is NOT an example of this.  The Hedrick maternity unit isn't closing its doors because the OB-GYN there left the state due to anti-abortion laws.   As @JohnSnowsHair said, if you just assign blanket blame to the Dodds decision anytime something like this happens, it actually hurts the credibility of the argument. 

It is a factor in the decision. I fail to understand how you cannot see it.

Republicans could care less about fatal fetal anomalies or the pain that this couple went through. They don't care about Americans, especially women.

Kentucky couple ‘furious’ state abortion laws meant they couldn’t hold their daughter to say goodbye

https://www.yahoo.com/entertainment/kentucky-couple-furious-state-abortion-114612223.html?spot_im_highlight_immediate=true&spot_im_comment_id=sp_Rba9aFpG_10e8d9be-5307-3ea8-9612-186670c4cab2_c_2SFJhadbMqwdJxhFyPfr95J6BmT&utm_source=spotim&utm_medium=e-mail&utm_campaign=liked-message&spot_im_redirect_source=email

"Anencephaly was confirmed.”

CNN reached out to three sponsors of Kentucky abortion laws to ask why fatal fetal anomalies aren’t an exception to the current laws. None of them responded.

10 minutes ago, toolg said:

It is a factor in the decision. I fail to understand how you cannot see it.

How is it a factor in the decision when they didn't lose OBs?  What, these OBs feel attacked working at Hedrick, but won't feel attacked working at North 90 miles away?  Was it a factor in the decision back in 2016 when Wright Memorial closed its maternity unit and the patients were sent to Hedrick?  

Was it a factor in the decisions to close maternity wards in Philadelphia that I cited?  How about the two that closed in Wyoming County, NY this year? NY coded abortion rights into state law in 2019. 

You're performing some very shoddy single variable analysis here....

25 minutes ago, Phillyterp85 said:

How is it a factor in the decision when they didn't lose OBs?  What, these OBs feel attacked working at Hedrick, but won't feel attacked working at North 90 miles away?  Was it a factor in the decision back in 2016 when Wright Memorial closed its maternity unit and the patients were sent to Hedrick?  

Was it a factor in the decisions to close maternity wards in Philadelphia that I cited?  How about the two that closed in Wyoming County, NY this year? NY coded abortion rights into state law in 2019. 

You're performing some very shoddy single variable analysis here....

Listen to the doctors: https://www.kff.org/womens-health-policy/report/a-national-survey-of-obgyns-experiences-after-dobbs/

Quote

Key Findings

ABORTION ACCESS AND CONSTRAINTS ON CARE SINCE DOBBS

• Since the Dobbs decision, half of OBGYNs practicing in states where abortion is banned say they have had patients in their practice who were unable to obtain an abortion they sought. This is the case for one in four (24%) office-based OBGYNs nationally.
• Nationally, one in five office-based OBGYNs (20%) report they have personally felt constraints on their ability to provide care for miscarriages and other pregnancy-related medical emergencies since the Dobbs decision. In states where abortion is banned, this share rises to four in ten OBGYNs (40%).
• Four in ten OBGYNs nationally (44%), and six in ten practicing in states where abortion is banned or where there are gestational limits, say their decision-making autonomy has become worse since the Dobbs ruling. Over a third of OBGYNs nationally (36%), and half practicing in states where abortion is banned (55%) or where there are gestational limits (47%), say their ability to practice within the standard of care has become worse.
• Most OBGYNs (68%) say the ruling has worsened their ability to manage pregnancy-related emergencies. Large shares also believe that the Dobbs decision has worsened pregnancy-related mortality (64%), racial and ethnic inequities in maternal health (70%) and the ability to attract new OBGYNs to the field (55%).

ABORTION POLICIES AND CONCERN ABOUT LEGAL RISK

• Two-thirds of OBGYNs nationally (68%) say they understand the circumstances under which abortion is legal in the state they practice very well. However, among OBGYNs in states where abortion is restricted by gestational limits the share is lower (45%) compared to those practicing in states where abortion is available under most circumstances (79%) or banned (68%).
• Over four in ten (42%) OBGYNs report that they are very or somewhat concerned about their own legal risk when making decisions about patient care and the necessity of abortion. This rises to more than half of OBGYNs practicing in states with gestational limits (59%) and abortion bans (61%).
• Eight in ten OBGYNs approve of a recent policy change from the FDA that allows certified pharmacies to dispense medication abortion pills.

ABORTION SERVICES

• Nearly one in five (18%) officed-based OBGYNs nationally say that they are providing abortion services after the Dobbs About three in ten OBGYNs (29%) practicing in states where abortion is available under most circumstances offer abortion care, compared to just 10% in states with gestational restrictions. There were already large differences between states prior to the Supreme Court’s ruling. Many of the states that have abortion restrictions today had these or similar restrictions in place prior to the Dobbs decision.
• Nationally, 14% of OBGYNs say they provide in-person medication abortions, but only 5% say they provide telehealth medication abortions.
• In states where abortion is banned, essentially no OBGYNs offer abortions, except under very limited circumstances. Additionally, nearly half (48%) of OBGYNs in these states only offer information, such as online resources, to help patients seek out abortion services on their own, but 30% do not even offer their patients referrals to another clinician or any information about abortion.

CONTRACEPTION

• More than half (55%) of OBGYNs nationally say they have seen an increase in the share of patients seeking some form of contraception since the Dobbs ruling, particularly sterilization (43%) and IUDs and implants (47%).
• Nearly all OBGYNs offer their patients some form of contraceptive care, but only 29% make all methods of contraception available to their patients, including all three methods of emergency contraception (copper intrauterine device (IUD), ulipristal acetate/Ella, and levonorgestrel/Plan B).
• Only one-third of OBGYNs (34%) prescribe or provide all three methods of emergency contraception and one in seven (15%) do not provide any methods of emergency contraception to their patients. A quarter of OBGYNS (25%) only prescribe or provide Plan B, which is available over the counter.
• Availability of care via telehealth expanded greatly after the onset of the COVID-19 pandemic. Today, almost seven in ten OBGYNs (69%) nationally say they provide at least some care via telehealth.

 

44 minutes ago, toolg said:

It is a factor in the decision. I fail to understand how you cannot see it.

You are conflating a general trend that has been going on well before Dobbs with a specific situation that has nothing to do with Dobbs. I think everyone here can agree Dobbs may amplify the trend but again that has nothing to do with this case. 

12 minutes ago, toolg said:

Listen to the doctors: https://www.kff.org/womens-health-policy/report/a-national-survey-of-obgyns-experiences-after-dobbs/

 

oh....my.....god...................

It's clear you aren't interested in an actual discussion here. You just want to perform this very flawed single variable analysis. You cited a closure of a maternity unit WHERE THE OB'S AREN'T LEAVING and say it's because of Dobbs.  When you find an example of a maternity ward closing because the OBs that work there have chosen to leave the state for bluer pastures, or decided to retire early from the job because of the extra headache their job now entails, THEN you can point to the Dobbs decision as a factor. 

I'll repeat what @JohnSnowsHair said:

If you continuously misrepresent and overstate the problem for political purposes you're going to be ignored during the times when abortion policy really does play a factor in these maternity ward mergers and closings.

But the problem predates the Dobbs decision, and while there are certain closures that you can point to as being primarily influenced by abortion policies in specific states, pointing to Dobbs every time a maternity ward closes just makes it easy to undercut the argument when it's applicable.

 

1 minute ago, Phillyterp85 said:

oh....my.....god...................

It's clear you aren't interested in an actual discussion here. You just want to perform this very flawed single variable analysis. You cited a closure of maternity unit WHERE THE OB'S AREN'T LEAVING and say it's because of Dobbs.  When you find an example of a maternity ward closing because the OBs that work there have chosen to leave the state for bluer pastures, or decided to retire early from the job because of the extra headache their job now entails, THEN you can point to the Dobbs decision as a factor. 

I'll repeat what @JohnSnowsHair said:

If you continuously misrepresent and overstate the problem for political purposes you're going to be ignored during the times when abortion policy really does play a factor in these maternity ward mergers and closings.

But the problem predates the Dobbs decision, and while there are certain closures that you can point to as being primarily influenced by abortion policies in specific states, pointing to Dobbs every time a maternity ward closes just makes it easy to undercut the argument when it's applicable.

 

It is clear you just want to perform this very flawed single variable analysis in MO, when I have stated there are reductions and closures of OB-GYN services across the entire country. Pardon me for making light of this health crisis. I guess we just have to wait for things to get worse before we can discuss it.

You're going to have a hard time linking shortages directly to the decision in the short run unfortunately given the already relatively high turnover rates of OBs and preexisting shortages. The bigger issue than OBs leaving jobs in those states (which would be easy to make a direct connection), will be new residents not electing to take jobs in those states, med students electing to not go into OBGYN because of the added government over reach and fear of liability, or the cost of convincing an OB to work in those areas becoming prohibitive to staffing a full unit. I think it's very safe to predict those will exacerbate an already worsening problem in staffing and poor maternal/fetal outcomes, but the direct connection to Dobbs is a lot murkier in the short run. 

17 minutes ago, toolg said:

It is clear you just want to perform this very flawed single variable analysis in MO, when I have stated there are reductions and closures of OB-GYN services across the entire country. Pardon me for making light of this health crisis. I guess we just have to wait for things to get worse before we can discuss it.

What are you talking about? What single variable analysis am I performing?  I'm pointing out the facts of what actually happened at the Hedrick maternity unit.  The single variable analysis is strictly isolated to you, where you're going "Dobbs overruled Roe v Wade, therefore this maternity unit closing must be related to that"

Did the OB at Hedrick leave the state and move to a state with less restrictive abortion regulations?  No.

Did the OB at Hedrick leave the practice? No.

Did this SAME EXACT THING HAPPEN to this SAME EXACT HOSPITAL SYSTEM in 2016?  Yes. 

 

 

 

My argument is the OB situation was already in decline, especially in rural and disadvantaged areas. Dobbs made it worse. And I guess it must continue to get worse for you to take notice.

19 minutes ago, toolg said:

It is clear you just want to perform this very flawed single variable analysis in MO, when I have stated there are reductions and closures of OB-GYN services across the entire country. Pardon me for making light of this health crisis. I guess we just have to wait for things to get worse before we can discuss it.

And yet no one mentions that the single highest cost to OB-GYNs is malpractice insurance and the rate they are sued.  This trend goes back nearly 20 years.

 

And the general trend of young doctors choosing more lucrative specialties. 

15 minutes ago, toolg said:

My argument is the OB situation was already in decline, especially in rural and disadvantaged areas. Dobbs made it worse. And I guess it must continue to get worse for you to take notice.

Once again, you are conflating a general trend and saying it applies to a specific situation in which it clearly was not a factor.

I agree, the Dobbs ruling will make it worse moving forward. It just isn't related to THIS specific situation you cited.  And trying to blame Dobbs every time a maternity unit closes only hurts your argument and will actually make it harder for people to believe you when a maternity unit actually does close because their OBs have decided to leave and go work in a different state with less restrictive abortion laws. 

This is like the people who tried to conflate the Philly bridge collapsing with the general trend in underfunding infrastructure.  It's like, yes, we have not been funding our infrastructure appropriately over the years, but this has absolutely nothing to do with that bridge collapsing. That bridge collapsed because a tanker truck exploded underneath it. 

How can you say it is not a factor? Dobbs already happened. The situation got worse. OB services will continue to decline. This is not occurring in a vacuum. If you had said a tanker truck exploded in the Hedrick maternity ward, then that would be an extenuating circumstance.